Provider Demographics
NPI:1013485507
Name:KAPARAMPIL, RESHMA ANN
Entity type:Individual
Prefix:
First Name:RESHMA
Middle Name:ANN
Last Name:KAPARAMPIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 SWEET BASIL LN
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-7856
Mailing Address - Country:US
Mailing Address - Phone:404-960-8204
Mailing Address - Fax:
Practice Address - Street 1:3230 SWEET BASIL LN
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-7856
Practice Address - Country:US
Practice Address - Phone:404-960-8204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224237-SW-LCSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker